Tropheryma whipplei Endocarditis: Case Presentation and Review of the Literature. (7th December 2018)

• Record Type: Journal Article
• Authors: McGee, Michael; Brienesse, Stephen; Chong, Brian; Levendel, Alexander; Lai, Katy
• Is Part Of: Open forum infectious diseases. Volume 6:Number 1(2019)
• Publication Date: 2018-12-07
• Subjects: endocarditis -- Tropheryma whippeli -- Whipple's disease; Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofy330
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Whipple's disease is a rare infective condition, classically presenting with gastrointestinal manifestations. It is increasingly recognized as an important cause of culture-negative endocarditis. We present a case of Whipple's endocarditis presenting with heart failure. A literature review identified 44 publications documenting 169 patients with Whipple's endocarditis. The average age was 57.1 years. There is a clear sex predominance, with 85% of cases being male. Presenting symptoms were primarily articular involvement (52%) and heart failure (41%). In the majority of cases, the diagnosis was made on examination of valvular tissue. Preexisting valvular abnormalities were reported in 21%. The aortic valve was most commonly involved, and multiple valves were involved in 64% and 23% of cases, respectively. Antibiotic therapy was widely varied and included a ceftriaxone, trimethoprim, and sulfamethoxazole combination. The average follow-up was 20 months, and mortality was approximately 24%. Physician awareness is paramount in the diagnosis and management of this rare condition.